Barbara Frazier, CCS-P, CRC
Medical Coder
Rockville,MD
Summary
Well-rounded certified coder with 10+ years of experience in medical coding, auditing, and billing processes. Skilled at accurately documenting diagnoses and procedures based on ICD-10-CM guidelines to ensure compliance with payer requirements and optimize reimbursement. Seeking a role as a Certified Risk Adjustment Coder. Proficiency in capturing HCC codes for Medicare Advantage, Commercial, and Medicaid risk adjustment models.
Overview
22
22
years of professional experience
2
2
Certifications
Work History
Coding Specialist II
US Acute Care Solutions
7 2022 - Current
- Assign accurate and relevant medical codes to patient records using ICD-10-CM, CPT, and HCPCS coding systems.
- Achieve accuracy (98%) and productivity (95%) standards consistently while coding 3000 charts/month.
- Maintain up-to-date knowledge of coding guidelines, regulations, and industry developments.
- Participate in quality improvement initiatives to improve coding accuracy and efficiency.
- Query healthcare providers to clarify documentation, enhancing th accuracy of medical records.
Assistant Coding Manager - ED
Alteon Health
06.2019 - 06.2022
- Manage workflow for 5-member coder team assigned to coding-related edits in Athena RCM platform
- Serve as SME (Subject Matter Expert) of complex billing issues for entire coding team
- Create centralized repository for coding resources, including workflow documents and job aids for all coding pre-bill edits in Coding Worklist Queue
- Conduct weekly meetings via Teams to support ongoing staff development
- Generate reports and collaborate with other RCM teams to identify and resolve payer denial trends; Manage ongoing coder review project of 10,000+ United Healthcare (UHC) and 7500+ Blue Cross (BCBS) claims; led to reduction of days in A/R.
Compliance Auditor
Alteon Health
01.2018 - 06.2019
- Audit medical records to ensure compliance with Medicare regulations and guidelines
- Experience accessing facility EMRs and reviewing records across all business lines: Emergency Medicine, Observation, Inpatient Services, Nursing Home, Skilled Nursing Facility
- Conduct regular follow-up audits to verify that previously identified issues were effectively resolved or mitigated; achieve revenue increase of $35/claim after hospital discharge audit education given to providers.
- Communicate audit results to management and Compliance Officer.
- Perform over one hundred compliance audits per month.
Medical Records Analyst - for CMS Audit Programs
Alteon Health
11.2014 - 01.2018
- Respond to Medicare Additional Documentation Request (ADR) and Targeted Probe and Educate (TPE) audits from CMS; 35 - 50 requests/week
- Perform qualitative chart reviews on 'medical necessity' claim denials
- Prepare appeal correspondence and/or initiate claim corrections for Medicare audit and overpayment claim denials; achieve 99% appeal success for Home Health overpayment project
- Maintain audit tracking spreadsheet and provide monthly reports to management.
Chart Reconciliation Specialist
Emergency Medicine Associates, P.A., P.C.
09.2009 - 11.2014
- Compare Emergency Department census data with billing data; coordinate efforts with Data Entry and Data Analytics department to ensure all charges are downloaded or entered into billing system accurately
- Report trends and issues during reconciliation to Coding Supervisor
- Enhance reconciliation accuracy by streamlining processes and implementing automated tools; decrease month-end deadline by five days
- Provide training for new team members on department procedures, fostering a supportive work environment and promoting skills development.
Medical Coder
Emergency Medicine Associates, P.A., P.C.
02.2002 - 09.2009
- Assign diagnosis and procedure codes for Emergency Department (ED) encounters.
- Manage all administrative tasks involved in preparing medical charts for coding; request missing documentation from hospital contact personnel.
- Maintain accuracy standards of more than 98% and productivity standards of 100% with coding 2500 charts/month.
- Demonstrate commitment to ongoing professional development by participating in relevant industry workshops and webinars to stay current with emerging trends in medical coding best practices.
Education
Bachelor of Science -
University of Maryland
College Park, MDSkills
CPT Coding
ICD-10-CM Coding
Insurance Claims Analysis
Workflow Management
Claim Edits/ Denials Resolution
Medicare Audits Process and Appeals
HCC Coding
Certification
CCS-P - Certified Coding Specialist - Physician-Based
EMR and RCM Platforms
- AthenaHealth
- NextGen Healthcare
- Allscripts
- Cerner
- Epic
- Meditech
Affiliations
American Academy of Professional Coders
American Health Information Management Association
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimePart TimeContract WorkLocation Preference
RemoteHybridImportant To Me
Work-life balanceFlexible work hoursWork from home optionHealthcare benefitsQuote
Three things in human life are important. The first is to be kind. The second is to be kind. And the third is to be kind.
Henry James
Timeline
Assistant Coding Manager - ED
Alteon Health
06.2019 - 06.2022
Compliance Auditor
Alteon Health
01.2018 - 06.2019
Medical Records Analyst - for CMS Audit Programs
Alteon Health
11.2014 - 01.2018
Chart Reconciliation Specialist
Emergency Medicine Associates, P.A., P.C.
09.2009 - 11.2014
Medical Coder
Emergency Medicine Associates, P.A., P.C.
02.2002 - 09.2009
Coding Specialist II
US Acute Care Solutions
7 2022 - Current
Bachelor of Science -
University of Maryland